JPGN reports最新文献

{"title":"Self-assessment with pediatric inflammatory bowel disease endoscopy scoring tools: A quality improvement pilot study.","authors":"Alexandra S Hudson, Ghassan Wahbeh, Dale Lee, Kendra L Francis, David Suskind, Hengqi Betty Zheng","doi":"10.1002/jpr3.70002","DOIUrl":"10.1002/jpr3.70002","url":null,"abstract":"<p><p>Endoscopy is a fundamental component pediatric gastroenterology (GI), with one of its primary applications being the evaluation and management of patients with inflammatory bowel disease (IBD). However, there is variation in education and experience of gastroenterologists with pediatric IBD endoscopy, which can affect the quality of patient care. This quality improvement pilot study assessed familiarity and comfort with key endoscopic assessment tools (13 questions) pre- and post- an evidence-based group presentation. Both fellow and attending pediatric gastroenterologists had low levels of comfort with endoscopic Crohn's disease scoring, IBD phenotype classification, postoperative IBD scoring, and IBD dysplasia screening. The review presentation significantly enhanced their comfort, with this effect persisting for several months among fellows. To improve the quality of care for IBD patients, it would be beneficial to periodically review endoscopic guidelines in continuing medical education for pediatric gastroenterologists providing IBD care.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"132-136"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic and rectal tube management of pediatric sigmoid volvulus: A case series.","authors":"Sapna Khemka, Micah Morris, Kevin Watson","doi":"10.1002/jpr3.12165","DOIUrl":"10.1002/jpr3.12165","url":null,"abstract":"<p><p>The process of the sigmoid colon twisting on its mesentery is known as sigmoid volvulus, a diagnosis rarely seen in the pediatric population. Volvulus can lead to blood flow obstruction of the colon and eventually perforation, necrosis, or sepsis. Predisposing factors include chronic constipation, chronic dysmotility, or Hirschsprung disease. This communication demonstrates three patients who presented to a tertiary pediatric care center with a diagnosis of sigmoid volvulus. All three patients underwent immediate endoscopic detorsion and rectal decompression tube placement. Two patients subsequently underwent surgical resection of redundant sigmoid colon. This communication highlights the use of sigmoidoscopy for detorsion of uncomplicated sigmoid volvulus with added support for initial rectal decompression tube placement, contributing to initial patient stabilization and positive patient outcomes.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"153-156"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clear approach: Hemostatic gel as a novel adjunct for pediatric upper gastrointestinal bleeding.","authors":"Natalia Plott, Audra Rougraff, Paroma Bose, Kyla M Tolliver, Shamaila Waseem, Brett J Hoskins","doi":"10.1002/jpr3.70000","DOIUrl":"10.1002/jpr3.70000","url":null,"abstract":"<p><p>Pediatric upper gastrointestinal bleeding (UGIB) is a significant clinical concern, with a mortality rate of approximately 2%. Endoscopic management of UGIB in children includes various techniques such as injections, mechanical devices, thermal therapies, and topical agents. PuraStat®, a clear hemostatic gel, has been used in adults to create a physical barrier for hemostasis without obscuring the endoscopic view. However, its use in pediatric UGIB has not been well-documented. A review of four pediatric cases where PuraStat® was used to treat UGIB showed that it was applied as an adjunct to other hemostatic methods like clip placement or epinephrine injections, and in one case, as monotherapy for a large duodenal ulcer/site of recently contained perforation. The gel was easy to use, appeared to be beneficial, and was well-tolerated in this small cohort, although conclusions regarding its safety and efficacy are limited by the sample size.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"157-161"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicenter study: New cut-off values of antitransglutaminase antibodies processed by chemiluminescence in children with suspected celiac disease.","authors":"Gonzalo Ortiz, Florencia Ursino, Fernando Battiston, Gabriela Messere, Veronica Busoni, Rosana Solis Neffa, Roman Bigliardi, Mabel Mora, Maria Del Carmen Toca, Marina Orsi","doi":"10.1002/jpr3.12169","DOIUrl":"10.1002/jpr3.12169","url":null,"abstract":"<p><strong>Objectives: </strong>(1) To assess the predictive value of anti-tissue transglutaminase immunoglobulin A (IgA) antibodies (a-tTG) by chemiluminescence immunoassay (CLIA) related to duodenal histology in children with suspected celiac disease (CD) and (2) to determine the cut-off value of a-tTG by CLIA that allows diagnosis of CD avoiding biopsy.</p><p><strong>Methods: </strong>Retrospective, descriptive, observational study in children between 1 and 16 years of age, studied for CD. Patients with IgA deficiency and those on a gluten-free diet were excluded. Sensitivity (S), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) were calculated for ≥10, 30, and 50 times the normal a-tTG (normal value [NV]) compared with histology, evaluated by blinded pathologists.</p><p><strong>Results: </strong>The total number of patients included was 262. The a-tTG IgA by CLIA with a cut-off point of 20 chemiluminescent units (CU) had a S of 99.5%, Sp, 10.26%, PPV, 86.38%, NPV, 80%. When a cut-off value of a-tTG ≥ 10 times NV (200 CU) was used, the S, Sp, PPV, and NPV were 65.4%, 69.23%, 94.2%, and 25.96%, respectively. Likewise, with a value ≥30 times NV (600 CU) the correlation with histology was 99.03%, reaching a PPV of 100% with a cut-off value ≥50 NV (1000 CU). Combining both methods a-tTG IgA + EMA IgA, we obtained similar results to the a-tTG IgA level for the proposed cut-off values.</p><p><strong>Conclusions: </strong>We suggest that the use of 30 times the NV cutoff values would be the best predictor of which patients do not need a biopsy.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"107-112"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of a hemostatic powder spray device for delivery through an incompatible endoscope.","authors":"Colin A Winkie, John M Grisham, Ethan A Mezoff, Steven H Erdman, Colleen B Flahive","doi":"10.1002/jpr3.12159","DOIUrl":"10.1002/jpr3.12159","url":null,"abstract":"<p><p>Hemostatic powder sprays are a valuable adjunct therapy in the management of gastrointestinal bleeds. Currently, available hemostatic powder spray delivery systems are designed for endoscopes with 2.8 mm operational channels. This limits their use in endoscopes with smaller operational channels designed for patients with atypical anatomy and small children. We report a case in which delivery of hemostatic spray was accomplished through a 2.2 mm working channel by way of after-market modification to the delivery system.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"199-202"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of low FODMAP diet in pediatric patients with disorders of gut-brain interaction.","authors":"Snigdha Raja, Jonathan E Teitelbaum, Kimberly Pereira, Katelyn Guli, Alexander Schosheim","doi":"10.1002/jpr3.12157","DOIUrl":"10.1002/jpr3.12157","url":null,"abstract":"<p><strong>Objectives: </strong>Disorders of gut-brain interaction (DGBIs), including irritable bowel syndrome (IBS), are common among children. Although a diet that is low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) has been proven to help adults with IBS, there is conflicting evidence of its efficacy in pediatric patients.</p><p><strong>Methods: </strong>This was a retrospective chart review of pediatric patients with DGBIs diagnosed by a pediatric gastroenterologist between December 2018 and April 2022 and referred to a dietician for low FODMAP diet (LFD). The diagnosis was based on Rome IV criteria, and the chart review was based on International Classification of Diseases 10 diagnosis codes for DGBIs. Subjective historical assessment was used to define symptom improvement. The causative FODMAP Monash group(s) were identified during the reintroduction phase based on a symptom diary.</p><p><strong>Results: </strong>A total of 58 patients were initially identified (38 females), 47 of whom completed the LFD and followed up. This included 24 patients with IBS-diarrhea predominant (IBS-D), 10 patients with IBS-mixed type (IBS-M), 6 patients with IBS-constipation predominant (IBS-C), and 7 patients with functional abdominal pain (FAP) or functional dyspepsia (FD). Symptom improvement occurred in 22 (91.6%) of IBS-D, 7 (70%) of IBS-M, 3 (50%) of IBS-C, and 3 (42.8%) of FAP/FD. Fructans, garlic, onions, and lactose were the most common offenders.</p><p><strong>Conclusion: </strong>LFD improves symptoms in most patients with DGBIs, particularly those with IBS-D.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of age at diagnosis on college adjustment in students with inflammatory bowel disease.","authors":"Angela Pham, Naueen A Chaudhry, Isaac Molina, Aniruddh Setya, Andrew Flint, Anna Dang, Laurie Wang, Tomas Potlach, Qian Li, Yi Guo, Molly McGetrick, Genie Beasley, Irene Estores, Laurie Keefer, Marla Dubinsky, Ellen M Zimmermann","doi":"10.1002/jpr3.12162","DOIUrl":"10.1002/jpr3.12162","url":null,"abstract":"<p><strong>Objectives: </strong>Little is known about the experience of college students with inflammatory bowel disease (IBD) and the factors associated with transition readiness, academic adjustment, and alternatively, those associated with academic hardship and attrition.</p><p><strong>Methods: </strong>Survey-based cross-sectional studies, including those addressing disease-specific quality of life (Short Inflammatory Bowel Disease Questionnaire), IBD disease activity (Harvey-Bradshaw Index and Patient Simple Clinical Colitis Activity Index), college adjustment (Student Adjustment to College Questionnaire), transition readiness (Transition Readiness Assessment Questionnaire [TRAQ]), and self-efficacy (inflammatory bowel disease self-efficacy scale).</p><p><strong>Results: </strong>The surveys were completed by 135 participants (59 IBD patients [37 Crohn's disease and 22 ulcerative colitis]; 76 controls). Participants with IBD were matched with respect to age, gender, academic status, and involvement in extracurricular activities. Participants endorsed making important college decisions associated with their disease and were significantly more likely to live at home (<i>p</i> < 0.001), take fewer credits (<i>p</i> < 0.02), and more likely than controls to have their education interrupted (<i>p</i> < 0.0005). Participant age at diagnosis was an important factor associated with college adjustment, with older age at diagnosis having the most association with the ability to adjust to college life. As expected based on prior literature, TRAQ scores suggested better than expected transition readiness in college students with IBD (<i>p</i> < 0.0006) with subscores revealing that female students are better at managing health issues and daily activities.</p><p><strong>Conclusion: </strong>IBD affects the college experience of students-patients significantly and can have life-long implications. Newly diagnosed students are at risk of poor college adjustment impacting academic performance and their future success. Male students are at greater risk than female students of poor transitioning to adult IBD care. Students with IBD should receive enhanced and age-specific modern IBD care.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"91-98"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial polyposis syndrome and achalasia in a young adult.","authors":"Gabriella A Lorusso Vivas, Ann-Christina Brady, Alejandro Llanos-Chea","doi":"10.1002/jpr3.12161","DOIUrl":"10.1002/jpr3.12161","url":null,"abstract":"<p><p>We report the case of a 19-year-old White male diagnosed with familial adenomatous polyposis (FAP), Gardner's syndrome (GS) phenotype, status post total colectomy, who developed progressive dysphagia and weight loss. He was diagnosed with achalasia based on imaging and esophageal manometry. The patient underwent a Heller myotomy with the resolution of symptoms. To date, no previous literature has reported on concurrent FAP or GS and achalasia. Although FAP and achalasia are both rare conditions with no previously known concurrent occurrence, association, or described syndrome, it is important to be vigilant of this new case report finding. One must also consider the increased risk of malignancy in patients with achalasia in addition to the significant risk of malignancy in patients with FAP/GS.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"166-169"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized biopsy protocols improve adherence to eosinophilic esophagitis and celiac disease endoscopic biopsy guidelines.","authors":"Sharon S Tam, Beth Williams, Rohit Kohli, Shehzad Saeed","doi":"10.1002/jpr3.12160","DOIUrl":"10.1002/jpr3.12160","url":null,"abstract":"<p><strong>Objectives: </strong>Optimal detection of eosinophilic esophagitis (EoE) and celiac disease (CeD) requires appropriate sampling of the upper gastrointestinal tract during endoscopy. However, endoscopic biopsy guidelines are poorly followed in clinical practice. A quality improvement (QI) initiative was undertaken to improve adherence to published EoE and CeD biopsy guidelines by creating standardized biopsy protocols.</p><p><strong>Methods: </strong>A biopsy form with disease-specific biopsy protocols was created and implemented. Endoscopists were initially asked to complete the form pre-procedure to indicate anticipated biopsies. After integration into the electronic health records (EHR), the form was completed by the primary treating clinician at the time endoscopy was requested. Data were collected through chart review of endoscopy and pathology reports. Statistical process control charts were used to analyze these metrics: adherence to biopsy guidelines (outcome measure), biopsy form utilization (process measure), and immediate and delayed procedural complications (balancing measures). Baseline adherence to biopsy guidelines was determined by retrospective chart review of upper endoscopies performed pre-intervention.</p><p><strong>Results: </strong>Overall adherence to biopsy guidelines improved from an average of 45% to 78.9% with our interventions. Improvement was sustained during the 2-year study period. Adherence to biopsy guidelines improved from an average of 55% to 84% for EoE and from 13.3% to 69.5% for CeD. Decreased variability in biopsy practice was noted over time. The EHR-integrated form led to consistently high utilization (>90%). Both immediate and delayed complications remained zero.</p><p><strong>Conclusions: </strong>Standardization of endoscopic biopsies using an EHR-integrated pre-procedure checklist leads to improved and sustained adherence to recommended EoE and CeD biopsy guidelines.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"113-120"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aeroportia and pneumatosis intestinalis in infants with food protein-induced-allergic proctocolitis: A presentation of two cases.","authors":"Jessica Ruesen, Clarissa Gaitan Villela, Theodoros Xydias, Freya Kramer, Corinne Daester, Henrik Koehler","doi":"10.1002/jpr3.12164","DOIUrl":"10.1002/jpr3.12164","url":null,"abstract":"<p><p>Bloody stools are a particularly concerning symptom in neonates and infants. The differential diagnosis reaches from life-threatening to benign conditions. We would like to present two infants, who presented to the paediatric emergency department with bloody stools and showed pneumatosis on ultrasonography, which initially led to the suspicion of a potentially life-threatening condition. Both children had an unremarkable physical examination and both the laboratory chemical parameters, as well as the stool analyses were without abnormal findings. As in summary, there was no evidence of necrotizing enterocolitis, and Food Protein-Induced Allergic Proctocolitis (FPIAP) was considered the most likely diagnosis, an ambulant nutritional counselling was provided. As FPIAP is a clinical diagnosis, the number of cases in which pneumatosis can be detected is unclear. It is speculated that, like atopic dermatitis, food allergies alter, for example, the tight junctions and lead to an increased intestinal permeability which might result in pneumatosis intestinalis.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"170-173"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}